Outline

Purpose: To evaluate the outcome of patients with birdshot retinochoroidopathy (BRC) treated with with mycophenolate mofetil (MMF, CellCeptÂ®) or mycophenolate sodium (MPS, MyforticÂ®).

Methods: We retrospectively reviewed the medical charts of patients with BRC who were treated with MMF or MPS and were evaluated consecutively over a 27-year period.

Results: Fourteen BRC patients (ratio female:male=9:5), all of whom were HLA-B29 positive, with a mean uveitis duration of 55.8 months (range 5–240 months) before MMF or MPS therapy were included. None of the patients had sufficient control of inflammation before initiation of MMF/MPS therapy even despite earlier immunosuppressive treatment (azathioprine n=1 pat., cyclosporine A n=2pat., steroids n=12 pat.). The follow-up consisted of 38.9Â±22.8 months (at least 6 months). None of the patients had to stop treatment due to side effects. Inflammation was reduced or stabilized in 12 patients (86%) and a steroid-sparing effect was achieved in all of the 12 patients. Average logMAR visual acuity (VA) before starting therapy was 0.36 (right eye) and 0.5 (left eye). Average final logMAR VAs were 0.4 (right eye) and 0.6 (left eye). Visual fields and ERGs were performed regularly over time on 10 of 14 patients; eight of ten patients demonstrated stabilized or even a slightly improvement.

Conclusions: Preservation of visual function is attainable with systemic MMF or MPS medication in patients with BRC. Prompt treatment with these immunosuppressives may offer a good chance for maintaining retinal function.